While Republicans were meeting in closed door sessions with Speaker Ryan and Donald Trump, trying to figure out a way to gut health care for Americans, my sister was undergoing the genetic testing for the BRCA gene. The test costs $4,000. We aren’t sure yet if her insurance will cover the test or not.

We need the answer to the test because my aunt and my uncle have had breast cancer. Since they are siblings that throws my sister into the high risk category for the BRCA. If her insurance pays for the test, and the test confirms the family for BRCA, that affects me, my brother, all of our children and our cousins and their children.

While all of this is going on, Republicans legislators, who have the best medical coverage taxpayers can afford, have devised ways to treat insurance plans like a banana split, letting people pick and choose the toppings they can afford. Why should I pay for mammograms? some of the Senators have asked. I’m a man. I don’t need mammograms, pap smears. I don’t want to pay for yours.

Thing is they can get breast cancer, too, especially if their family is confirmed for the BRCA.

Not only does my sister have breast cancer, but my niece was diagnosed about the same week as my sis with cancer. She began a six-month regime of chemo this week. She’s in her 30s. Thankfully, she lives in an urban area and has insurance and access to great medical care, still there were all sorts of mishaps. An inconclusive biopsy that had to be repeated. Snow and ice delays. Puzzling lack of symptoms that would typically accompany such a disease.

I wonder if the Republicans had their way if my niece would have been covered for that second biopsy that confirmed the cancer, or if under the Republican’s plan such a procedure would have been ruled extravagant.

Trump and Ryan are so intent on punishing the poor for being poor and rewarding the rich for being rich that they are threatening legislators to pass their health care bill, or else…

And because Trump touts himself as the negotiator – his term for being the biggest bad ass bully on the block – he and Ryan have even agreed to the most right-wing contingent of the party to eliminate what have long been considered “essential health benefits”. In case you are unfamiliar with essential health benefits, here’s a run-down:

Outpatient care — This covers most scheduled doctor visits, such as to check a rash, or a non-emergency stomach ache. Insurance companies negotiate deals for these and often designate “networks” of doctors and clinics with approved charges. Individuals who walk in without coverage pay much, much more.

Emergency room trips — Insurance policies cover both the ER visit and ambulance trips. Otherwise people can get socked with bills totaling tens of thousands of dollars, perhaps incurred while they were unconscious.

In-hospital care — All care people get as hospital patients, such as surgery. Some conservatives argue that people should be able to choose to opt out of this type of coverage and pay lower premiums. Most health policy experts say this is a gamble. “One answer is because someday you may be sick and that’s the way that insurance works,” says David Cutler, a Harvard University economics professor who helped design the Affordable Care Act.

Pregnancy, maternity and newborn care — This one’s controversial to some, who ask why men should pay for a service they’ll never use.

Mental health and substance abuse disorder services — This particular benefit has gotten some attention with the ongoing opioid epidemic.

Prescription drugs — Insurance companies usually negotiate discounts. Out of pocket costs for many drugs can be much higher than what an insurer pays for them.

Rehabilitative services and habilitative services. These include help recovering from an injury or illness, but also treatment for kids with autism or cerebral palsy.

Lab tests

Preventive services — This includes vaccines, cancer screenings such as mammograms and colonoscopies and, controversially, coverage of birth control.

Pediatric services — Including dental and vision care for children.

Looking at this list it makes you wonder, what’s the point of insurance that isn’t required to cover the essentials, huh?

Men, there are a bunch of us women out here wondering why you aren’t raising your voices loudly in unison against Trump and Ryan on this. While it is true you can’t get pregnant, you can’t father a child without help from a woman. And while it’s true you won’t ever get uterine cancer, doesn’t mean that a woman you love won’t. And while, yeah, breast cancer typically affects women, men are not immune from it. One in eight women will suffer breast cancer. One in a thousand men will as well.

If the Republicans are able to gut the essential health benefits as Trump and Ryan have suggested, you can bet that the insurance coverage you currently have is going to be affected as well.

And while I understand the need for health care/coverage reform in this country, I don’t think this is the path the wealthiest country in the world should be pursuing.

These decisions are affecting somebody’s loved ones.

Maybe your own.

Karen Spears Zacharias is author of BURDY and the forthcoming CHRISTIAN BEND (Mercer University Press).

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5 Comments

I regularly dialogue with a very conservative friend (Air Force buddy) who regularly takes issue with health care as a right. To him, it's an earned privilege, and if you want it when you need it, well... you should have planned ahead and had the right career, etc. He doesn't want to pay for someone else's health insurance or health care because he feels, well, that they haven't earned it. For the government to create a system requiring him to subsidize someone else is "nanny state" meddling and redistribution of wealth from the rich to the poor to which he strongly objects. Not much headway to be made in that discussion because the vocabulary is an obstacle at the outset. To get away from that, I can only think of two ways forward. 1) As just a preliminary clearing of the air we might first ask whether "wealth" ever engages in redistribution of wealth from the poor to the rich and whether that in fact comes at a high cost to all of us. 2) Leaving that to simmer, we might then be ready to ask not whether health care is a "right" but a universal human NEED. If so, what is the cost of leaving that need untreated, badly treated, poorly treated or treated at a cost that diminishes life and bankrupts people, even forcing them into homelessness? Does it "cost" me something as a human being if this happens to my family, my neighbors, my community? I think it does, and the price is too high, especially if there is another way. The only way of reducing the cost of health insurance is to make it cover less (essentially making it worth less, or worthless), or to arbitrarily tomorrow mandate that all salaries and treatments and pharmaceuticals across the board undergo a 30-50% salary and price cut within the next year, or by reducing the administrative overhead for the ungodly cumbersome and redundant billing and payment system we refuse to recognize and let go of in USA. That wasted money delivers no health and no health care but it adds a ton of cost. I guess we could also mandate that the cost of education and training in the health care professions get cut 50%, or even transform it into a national service like the military and pay it entirely through taxes. Journalist T. R. Reid's book of eight years ago The Healing of America is as timely as ever. I doubt many Republicans have read it or would sit still long enough to do so. Until we are able to think better about our fellow human beings and be more realistic about true "costs" to life, liberty and the pursuit of happiness, until we more highly value the lives of our fellow human beings that we have the power to heal, we will stay stuck where we are: engaging in a tragic charade to make doing less look like doing more.

How does your friend feel about subsidizing corporations? About providing security all across the globe for the entire Trump clan? About keeping Ms. Trump in NYC while her husband holes up in DC or Florida? Is this okay with him? Is it okay with him that we spend millions on a wall that is completely worthless? Is he okay with pouring money into coal businesses so that they can continue to destroy our lands, our waters, our people?

How does my friend feel about those things? Best answer I can give is that we have no feelings about what we cannot or choose not to "see". It's so much easier to single out individuals or groups of people than a whole system or corporations I own stock in so I can have a more secure retirement. Seeing is the issue. Not seeing, that's the problem. Seeing is the central nervous system of the entire Gospel According to John. See especially chapter 9. After all is said and done, there's a sobering question at the very end. See Jesus' stunning answer to it...

Since your discussion began with the implications of cancer on your extended family, I wanted to add a special shout-out and urgent appeal to all of your readers. For many cancer patients, there is a priceless gift that we have an abundance of in our bodies and can make more of nearly overnight: blood platelets. They can be extracted from whole blood through a process known as apheresis available at any Red Cross Donor Center. The rest of the blood is returned to the body, and a donor can give a double or triple unit of platelets--and be able to donate again, if they so choose, only a week later. Platelets have only a five day life expectancy, the first three days of which are taken up by testing and transport. There is NEVER an oversupply of platelets, and inclement weather that forces donors to cancel appointments is devastating to the supply--and to the people in treatment who desperately need them to rebuild the body's own defenses against cancer. Why do I donate? Because my Dad was a cancer survivor. And my Mom who was a four-time cancer survivor lived to be 105. And someday soon, I will likely need them myself. We all might. No lab can make this stuff. Only we can, and we do. Only we can give. Please do. Amen.

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About Karen

Karen Spears Zacharias

Karen grew up in a military family. Her father was killed in action in 1966. That early experience led Karen into a career as a journalist. She studied at Berry College, Oregon State University and Eastern Oregon University.
Karen has worked at newspapers around the country. Her commentary has been featured in the New York Times, Washington Post, Newsweek, CNN, National Public Radio and The Huffington Post.
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